When should I get a fertility test?

Infertility can be a challenging and emotional experience for couples who are trying to build their family. Many factors can contribute to infertility, including age, genetics, and lifestyle choices. However, many effective treatments are available to overcome infertility and achieve your dream of having a baby.

What Are the Basic Infertility Evaluation Fertility Tests and When You Should Have Them

The first step in addressing your or your partner's infertility is to undergo fertility testing to determine the underlying cause.

When to Seek Fertility Evaluation

Infertility is generally defined as the inability to conceive after one year of unprotected sex. However, for women over 35, infertility is defined as the inability to conceive after six months of trying. However, some couples may have underlying medical conditions that affect their ability to conceive even before trying for a year.

Couples with a history of certain medical conditions or lifestyle factors affecting fertility should seek fertility evaluation even before trying to conceive. These include:

• Women over the age of 35

• Irregular menstrual cycles

• Endometriosis

• Polycystic ovary syndrome (PCOS)

• Pelvic inflammatory disease (PID)

• Previous surgeries in the pelvic region

• Male infertility factors, such as low sperm count or erectile dysfunction

• Family history of genetic disorders

• Cancer treatments

If you and your partner have been trying to get pregnant without any success, it might be time to consider seeing a physician for a fertility evaluation.

The Importance of Early Evaluation

It's essential to seek fertility evaluation early, as early diagnosis can lead to better treatment outcomes. Identifying the underlying cause(s) of infertility is the first step toward developing a personalized treatment plan. Couples who delay seeking fertility evaluation may have reduced chances of successful treatment, especially if age is a factor.

Basic Infertility Evaluation Fertility Tests

Fertility testing begins with a comprehensive evaluation of both partners to determine infertility's underlying cause(s). The following tests are commonly performed as part of a basic infertility evaluation:

Hormone Testing

Hormone testing involves measuring the levels of hormones that regulate the reproductive system in both men and women. These tests help to identify hormonal imbalances that may affect fertility. For women, tests may include:

• Anti-Müllerian hormone (AMH) level: This blood test measures ovarian reserve, the number of eggs remaining in the ovaries. It can predict a woman's response to fertility treatments and indicate ovarian aging.

• Follicle-stimulating hormone (FSH) level: This blood test measures the hormone that stimulates the ovaries to produce eggs. High levels of FSH indicate decreased ovarian reserve, which can impact a woman's response to fertility treatments.

For men, hormone testing may include the following:

• Testosterone level: This hormone is essential for sperm production. Low levels of testosterone can cause male infertility.

• Luteinizing hormone (LH) level: This hormone stimulates testosterone production in men.

Semen Analysis

A semen analysis is a basic test that evaluates sperm quality and quantity. The test measures the number, motility (the ability to move and swim), and morphology (the shape and size) of sperm. Abnormal results may indicate issues with male fertility.

Imaging Tests

Imaging tests are used to assess the reproductive organs for structural abnormalities. These may include:

• Transvaginal ultrasound with antral follicle count: This test evaluates the uterus and ovaries and measures the number of follicles in the ovaries. It can predict a woman's response to fertility treatments and indicate ovarian aging.

• Hysterosalpingogram (HSG): This is a specialized X-ray that evaluates the uterus and fallopian tubes. It is used to identify structural defects that may interfere with embryo implantation or predispose to miscarriage.

• Sonohysterogram or Salinesonogram: This test is a particular type of transvaginal ultrasound that evaluates the innermost space of the uterus, where the embryo implants. It can identify uterine abnormalities such as polyps, fibroids, intrauterine scar tissue, and structural abnormalities such as uterine septum.

Other Diagnostic Tests

Additional diagnostic tests may be recommended depending on the complexity of the case. These tests may include the following:

• Genetic testing: We recommend all couples undergo genetic carrier screening. Couples with a family history of genetic disorders may undergo additional genetic testing to identify potential genetic abnormalities.

• Endometrial biopsy: This test evaluates the uterine lining to assess its receptivity to embryo implantation and rule out endometritis (underlying infection).

• Laparoscopy: This minimally invasive surgical procedure allows for evaluating the reproductive organs. Once done routinely, it is now reserved for patients with known issues such as endometriosis and hydrosalpinx (fluid in the fallopian tubes). It is necessary to remove infected fallopian tubes prior to embryo transfer, even when using IVF to create embryos. A laparoscopy is usually combined with a hysteroscopy to assess and treat uterine issues, such as polyps or submucosal fibroids, which could impact the implantation of a fertilized egg (embryo).

What to Expect During the Evaluation Process

The fertility evaluation process typically involves an initial consultation with a fertility specialist, a medical history review, a physical exam, and diagnostic tests. The following are the critical steps involved in the evaluation process:

Initial Consultation and Medical History

During the initial consultation, the fertility specialist will take a detailed medical history of you and your partner. Your specialist will review any previous medical conditions, surgeries, or treatments that may impact your fertility. This information is essential in developing a personalized treatment plan.

Physical Exam and Testing

The fertility specialist will conduct a physical exam and perform diagnostic tests based on the medical history review. This may include blood tests, semen analysis, imaging tests, and other diagnostic tests, depending on your case.

Follow-Up Appointments and Treatment Options

After completing the diagnostic tests, the fertility specialist will review the results and develop a personalized treatment plan. Treatment options may include lifestyle changes, medication, intrauterine insemination (IUI), or in vitro fertilization (IVF). The fertility specialist will monitor the couple's progress during treatment through follow-up appointments.

What to Do After Receiving the Results

It’s essential to understand what the results of the fertility evaluation mean and the available treatment options. Discuss your options with your fertility specialist and make informed decisions about your treatment plan. Coping with the emotional impact of infertility can also be challenging, and you and your partner may seek counseling or support groups to help you through this often-stressful time.

Early Testing Allows for Early Treatment

Infertility can be a challenging and stressful stumbling block on the journey to parenthood. Still, with the correct diagnosis and treatment, achieving your dream of starting a family is possible. Basic fertility tests are crucial in identifying the underlying causes of infertility and creating a customized treatment plan, and it's vital to seek evaluation early if you're experiencing fertility issues. Contact our caring fertility specialists today to take the first step.

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